| NPI | 1932316403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN BRUCE WALCOTT Direct Owner 973-673-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ MA59554) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |